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MOLECULAR BIOLOGY, NUCLEIC ACIDS, AND THEFUTURE OF MEDICINE* E. L. TATUM\ It seems particularly fitting, in this symposium, to try to assess the probable and possible impact of molecular biology and its important component , the structure and function of nucleic acids, on the future of medicine. Although I attempt specific predictions with considerable trepidation , not being qualified in either fortunetelhng or medicine, I do so in the firm belief that the findings and concepts of molecular biology will play a leading role in the future ofmedicine. Medicine, after all, primarily involves the application of biological concepts and understanding to the health and welfare of man. After considering various alternative presentations, I have decided first to point out some ofthe principal problem areas facing medical science in which molecular biology is most immediately concerned. I will then do my best to predict some developments in these areas over the next ten to twenty years. Before doing this, however, I feel a real obligation to mention a problem that is peripheral in one sense, but that in another is related to and even supersedes most others in basic importance to man. This is the world problem ofpopulation and the means of arriving at and maintaining an effective balance between the population explosion and natural resources. Although this problem is outside the main thread ofthis symposium, it is actually ofprimary importance. Unless it can be solved, and a new "dark * This paper was presented atthe dedication symposium ofthe new research laboratories ofMerck Sharp and Dohme in New York, May, 1966. Columbia University College of Physicians and Surgeons was ajoint sponsor. All the papers presented will be published in book form by Merck & Co. Cost ofpublication ofthis article has been covered by the National Foundation. t Rockefeller University, New York, New York. 19 age" avoided, scientific progress can hardly be maintained, and the application to man ofnew findings will be defeated by sheer numbers. However, let us assume that this problem will be solved, and proceed to problem areas in medical science. Some ofthe most important ofthese are being discussed by the other symposium speakers, auto-immune diseases by Sir Macfarlane Burnet, brain function by Dr. Schmitt, and degenerative diseases by Sir George Pickering. Accordingly, I will concentrate primarily on the following areas in which progress seems to me to be particularly directly related to the concepts of molecular biology and dependent on nucleic acid research. These major areas are: (i) viruses and virus diseases; (2) hereditary metabolic defects, enzymatic, and regulatory; (3) developmental, congenital, and structural defects; and (4) cancer. What developments can be predicted in these general areas during the next twenty years or so? In the field of viruses and viral diseases, it can be anticipated fairly confidently that the study of viruses—bacterial, plant, and animal—will continue to hold as important a place in molecular biology and genetics as has been true during the past decade or so. Most, ifnot all, viral diseases will be conquered either through immunological means or by the design and synthesis ofspecific antiviral chemicals. With this, and with definitive understanding of the roles of viruses in human problems involving development and with regulation of cell growth, will come effective prevention and hence control ofhuman problems attributable to viral disease. Finally, it can be anticipated that viruses will be effectively used for man's benefit, in theoretical studies in somatic-cell genetics and possibly in genetic therapy. In the area of metabolic disorders, the recognition ofthe genetic basis ofmany more disorders can be anticipated. The specific enzymatic defects will be identified in many more instances, as already has been done for PKU (phenylketonuria), galactosemia, certain amino acidurias, and abnormalities in hemoglobin and other serum proteins. Rapid, simple, and sensitive methods for the detection ofcarriers and for the early diagnosis ofaffected individuals will be developed, thus facilitating both more effective eugenic measures and more effective therapy by dietary and other means. We can even be somewhat optimistic on the long-range possibility oftherapy by the isolation or design, synthesis, and introduction ofnew genes into defective cells ofparticular organs. 20 E. L. Tatum · Molecular Biology and Medicine Perspectives in Biology and Medicine · Autumn 1966 In the field of...


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